Have you ever been convicted of any violations of the Law, excluding traffic violations and Health and Safety Code sections 11357, 11360, 11364, 11365 or 11550 related to marijuana prior to 01/01/1976? A conviction is not necessarily a bar to employment. Each case will be given individual consideration, based on relevance to the position. * Required

Yes

No

If yes, explain

Education and Training

High School Graduate? * Required

Yes

No

High School Equivalency? * Required

Yes

No

Name and Location of High School

Name and Location of College

Degree/Certificate

Date You Received Your Degree - must be mm/dd/yyyy format

Name and Location of Graduate School

Degree/Certificate

Date You Received Your Degree - must be mm/dd/yyyy format

Other Job Related Skills

Computer Programs

Languages Spoken/Written

Volunteer or Employment History

Starting with the present or most recent experience, provide the following information for all employment during the past 10 years. You may attach a resume or a supplemental sheet, but this section must be completed. Include volunteer employment, if applicable.

Emergency Contact Information

Are there any health conditions or medications that we should know about in case of emergency?

If yes, please explain

Fingerprints

The Town of Colma is required by law to have all individuals age 18 years and older, working in a position that is sensitive (involving children or confidential material) to be fingerprinted. If you have registered to volunteer in any of these areas, the following steps must be followed before you will be allowed to volunteer.
We hope that this will not be too great of an inconvenience. We are sure you understand the importance of this law. If you have any questions, please contact the Recreation department.
When filling out the fingerprinting card, be sure to use only BLACK ink and clearly print all personal information. Please contact the Colma Police Department at 997-8321 to schedule an appointment for Livescan fingerprinting.

CERTIFICATION OF APPLICANT

The Town of Colma will provide the Volunteer the following:
* Training and orientation to allow the volunteer to meet the responsibilities of his/her position.
* Letter of reference (upon request).
* Worker’s Compensation benefits in case of injury.
* Must be a registered volunteer with the Town and must regularly submit time cards .
* The same respect given to paid Town staff and deference given to a valuable Town asset .
* Ongoing evaluations and feedback.As a Volunteer for theTown of Colma agree to the following:
* Perform my duties to the best of my ability.
* Regular and prompt attendance. I will notify my supervisor as soon as possible when unable to work.
* Record hours on a daily time card and submit them to the Recreation Department at the end of each month.
* Observe policies and procedures of the Town and the department where assigned .

(Carefully read before signing): I certify that the information contained in this application is correct to the best of my knowledge and understand that falsification of this application in any detail is grounds for disqualification or dismissal from employment or volunteering. I agree to conform to the rules and regulations of the Town of Colma. I consent to inquiries regarding my past employment. I further understand that I may be fingerprinted, required to submit to a complete medical and/or psychological examination. I release all parties and persons connected with any request for information from all claims, liabilities and damages for whatever reason arising out of furnishing this information. DISABLED APPLICANTS: The Human Resources Office may have resources to assist you in the exam process. If you have special needs, please call (650) 997-8300. EOE

Signature

Minors Release

I herby give permission for my child to participate in Colma’s Volunteer Program. I understand that he/she is working on a voluntary basis and there exists no employment relationship between my child the Town of Colma.
I further agree to hold harmless the Town of Colma in regard to any personal injury sustained by my child during the time he/she is engaged in the voluntary activities with the Town.